Nodal status in predicting the outcome of treatment with definitive chemoradiation in patients with cervical cancer in FIGO IIIC1 and IIIC2 stages

Background : The 2018 International Federation of Gynecology and Obstetrics (FIGO) classification redefined stage III of locally advanced cervical cancer into substages IIIC1 pelvic and IIIC2 para-aortic lymphadenopathy, ignoring the number and size of lymph nodes. The aim was to analyse of the volume burden influence of the primary tumor and pathological lymph nodes, on the three-year overall survival (OS) and progression free survival (PFS), in cervical cancer patients FIGO stages IIIC1 and IIIC2 treated with definitive chemoradiation. Materials and methods : A retrospective clinical study based on the analysis of three-year OS, PFS and factors that may influence the time to disease progression in cervical cancer patients in FIGO IIIC1 and IIIC2 stages treated from January 2020 to January 2024 with external beam radiotherapy (EBRT) with simultaneous integrated or sequential boost doses, brachytherapy and chemopotentiation at the Radiation Oncology Center of the UCC Kragujevac. Results: The study included 92 patients whose three-year OS was 68.5%, while PFS was 57.6%. The influence of age, comorbidity, belonging to stage IIIC1 or IIIC2, pathohistological tumor characteristics, number, total volume (GTVn) or the presence of a conglomerate of lymph nodes, tumor volume (GTVt), treatment duration over 56 days and radiotherapy technique on the length of PFS was examined. The length of PFS is influenced by treatment duration over 56 days, GTVn, number and conglomeration of lymph nodes, and EBRT dose (p < 0.05). Conclusion: The number and total volume of lymph nodes have a statistically significant effect on the length of PFS in FIGO stage IIIC1 and IIIC2 cervical cancer patients treated with definitive chemoradiation.